Bandage for wound or incision closure

ABSTRACT

Disclosed is a bandage for closing a wound or incision, and methods for the use of same. The bandage comprises a first flat flexible component having adhesive on a lower surface and one or more first elongated connectors extending in an offset manner from one edge thereof in a first direction. The bandage further comprises a second flat flexible component having adhesive on a lower surface and one or more second elongated connectors extending in an offset manner from one edge thereof in a second direction generally opposite to the first direction. Pulling elements are joined to the first and second elongated connectors. Means are provided for attaching the first elongated connectors to the second flat flexible component and the second elongated connectors to the first flat flexible component.

BACKGROUND OF THE INVENTION

[0001] Compositions and methods for wound or incision closure are knownin the art. The use of sutures or staples to close a wound or incisionrepresents the most common of these prior art techniques. The use ofsutures or staples is an invasive technique which can be painful andfrequently the use of an anesthetic is required. These processes oftenleave unsightly scars, both from the insertion holes and from varyingtensions applied to the wound or surgical incision between the suturingpoints and intervening spaces. Moreover, these methods necessitatefollow-up visits to a hospital or doctor's office for removal.

[0002] Although other compositions and methods for closing wounds orincisions are known in the art, these have not gained popular acceptancedue to limitations in their design. There is a clear need for non-, orless invasive method for wound or incision closure which is practicaland easy to use.

SUMMARY OF THE INVENTION

[0003] The present invention relates to a bandage for closing a wound orincision. The invention was originally disclosed in compliance with theU.S. Patent Office Disclosure Document Program as Disclosure DocumentNumbers 448,944 and 446,186. In a preferred embodiment, the bandagecomprises a first flat flexible component having adhesive on a lowersurface and a plurality of first elongated connectors extending from oneedge thereof in a first direction. The bandage further comprises asecond flat flexible component having adhesive on a lower surface andone or more second elongated connectors extending from one edge thereofin a second direction generally opposite to the first direction. A firstpulling element is joined to the first elongated connectors and adaptedfor lateral translation of the first flat flexible component toward awound edge. A second pulling element is joined to the second elongatedconnectors and adapted for lateral translation of the second flatflexible component toward the wound edge. The pulling elements tend tospread the pulling force provided by a person applying the bandage ofthe present invention across each of the elongated connectors to whichit is attached. A means for attaching the first elongated connectors tothe second flat flexible component and means for attaching the secondelongated connectors to the first flat flexible component are provided.

[0004] The adhesives provided on the lower surface of the first andsecond flat flexible components are selected based on theircompatibility with the skin, as well their ability to securely hold thebandage for a period of time sufficient for the wound to heal. A varietyof such adhesives are known in the art. Prior to application, theadhesives are protected from contamination and oxidation by one or moresheets of a protective film. The film is removed prior to application ofthe bandage thereby exposing the adhesive.

[0005] In embodiments of the present invention in which the first andsecond flat flexible components are thin and extremely flexible, theadhesive protecting film may be selected to provide a degree ofstiffness which aids in application of the bandage. Multiple protectivefilms may be provided to protect the adhesive on a single flat flexiblecomponent, thereby providing convenient locations to grip the top andprotected bottom of the bandage with the fingers during application.

[0006] The means for attaching the first elongated connectors to thesecond flat flexible component, and the second elongated connectors tothe first flat flexible component, are also, in preferred embodiments,adhesives. When the flat flexible components are applied, and a desiredtension is reached effecting wound or incision closure, the elongatedconnectors are brought into contact with the flat flexible componentsand an adhesive fixes their positions relative to one another. It willbe recognized that during manufacture, the adhesive may be applied tothe upper surfaces of the flat flexible components, to the lowersurfaces of the elongated connectors, or to both. A variety of pressuresensitive adhesives are appropriate for this application and the choiceof which adhesive to employ is largely one of design choice andoptimization. As was discussed above in connection with the adhesive onthe lower surfaces of the flat flexible components, the adhesives areprotected prior to application with a thin removable film.

[0007] The sizes of the various components are variable withinparameters defined by functional considerations. For example, the lengthof the first and second flat flexible components (i.e., in a dimensiongenerally parallel to the wound or incision), must be approximately thesame length as the wound or incision to effect closure. To a largeextent, the length of the first and second flat flexible components(which is determined based on the length of the wound or incision)determines the width of the first and second flat flexible components(i.e., the dimension perpendicular to the length of the first and secondflat flexible components in the plane of application). In other words,the relationship of length to width must be selected such thatsufficient adhesive may be applied to hold the bandage in place onceapplied to the skin. If the width of the bandage is too small, relativeto its length, the bandage will be insecure when applied and susceptibleto premature and unintended separation from the skin. The determinationof length to width ratios are empirical in nature andadhesive-dependent. Generally speaking, an acceptable length to widthratio may be from about 1:2 to about 8:1. These ratios are provided asexamples, with no attempt being made to provide maximum or minimumratios.

[0008] Another consideration which relates to the sizing of the elementsof the bandage of the present invention is the spacing between theelongated connectors. It is important that there be sufficient spacebetween adjacent elongated connectors to allow adjustment of the firstand second flat flexible components relative to one another. Morespecifically, in application, one of the two flat flexible components isapplied to the skin before the other flat flexible component. Followingapplication, this flat flexible component is not easily removed andrepositioned. Therefore, having sufficient spacing between the elongatedconnectors is important to facilitate fine adjustment of the unattachedflat flexible component relative to the attached flat flexiblecomponent. There is no absolute minimum which can be stated with respectto spacing between elongated connectors. Preferred ranges are probablybest stated as a percentage of the bandage length. For example, aspacing between adjacent elongated connectors of between about 5% toabout 10% of the bandage length (as defined above) is an example of anappropriate range.

[0009] In preferred embodiments the flat flexible components, elongatedconnectors, and pulling elements described in the preceding paragraphare produced from a substantially inelastic polymeric material.Alternatively, they may be produced from an elastic material which isreinforced with an inelastic structural component thereby rendering thedevice substantially inelastic. For example, such inelastic materialsmay include monofilament polymeric line or mesh. Reinforcement of theflat flexible components along the wound edge, and of the pullingelements, is preferably done using a material which is both rigid andinelastic (e.g., a rigid polymer is a preferred material for thispurpose).

[0010] In preferred embodiments, the flat flexible elements, elongatedconnectors and pulling elements are produced from sheet stock (e.g.,plastic sheet stock). Die cutting these elements from plastic sheetstock to provide monolithic components which are subsequently joined toproduce a functional bandage is a particularly cost-effective approach.The sheet stock may be perforated to allow for the exchange of air withthe skin beneath the bandage. The thickness of the sheet stock may varydepending upon application. In addition, as discussed above, portionsmay be reinforced with a rigid material as needed.

[0011] In preferred embodiments, the first and second pulling elementsare removable following application of the bandage to the skin. Thisfeature minimizes the bandage size following application to the patient.This decrease in the overall size of the bandage reduces the chance thata portion of the bandage may be caught, for example, on clothing or apillow. Such an occurrence could tend to pull the bandage away from theskin thereby causing the wound or incision to open. Minimizing theoverall size of the bandage following application also tends to providefor a more comfortable fit.

[0012] A preferred design which provides for the removal of the pullingelements includes in-line perforations or scoring along the first andsecond elongated connectors. By breaking the elongated connectors alongthese perforations, the first and second pulling elements are removed.

[0013] In a preferred embodiment of the bandage of the presentinvention, the first and second elongated connectors are interleaved.The interleaving of the elongated connectors can be effected in avariety of ways which will be apparent to one of skill in the art. Byway of example, at least one member of the pair of flat flexiblecomponents and elongated connectors may be die cut as a single unit,while die cutting the corresponding pulling element separately. Thefirst and second elongated connectors may then be interleaved, followedby attachment of the individually die cut pulling element to theappropriate elongated connectors using, for example, an adhesive.

[0014] Another method for assembling an interleaved embodiment is mostreadily described by way of example. A first monolithic componentcomprising a pulling element, a pair of first elongated connectors, anda first flat flexible component is provided. A second monolithiccomponent comprising a pulling element, three second elongatedconnectors, and a second flat flexible component is provided. Theelongated connectors are spaced such that they would interleave, ifmated, but for the fact that the middle second elongated connector(being fixed at each end) prohibits the mating of the two elements. Inorder to mate the two monolithic components it is necessary to cut thismiddle second elongated connector, mate the two monolithic componentssuch that the elongated connectors interleave, then reattach the middlesecond elongated connector. Clearly this method of assembling appliesalso to embodiments having more than 5 total elongated connectors.

[0015] An alternative to the interleaved embodiments described above hasbeen termed the wide key-hole design. In this design, two monolithiccomponents are manufactured (e.g., by a die cut process). Each of thetwo monolithic components comprise a first flat flexible component,elongated connector(s) and a pulling element. The elongated connector(s)of the first monolithic component are all adjacent to one another andcentrally located in the assembled and applied bandage. The elongatedconnectors of the second monolithic component flank those of the firstmonolithic component lying toward the outside edges of the bandage. Thisdesign facilitates manufacture because both monolithic components can bedie cut in a conventional manner, then the first monolithic componentmay be inserted into the relative wide opening between the two sets ofelongated connectors in the second monolithic component. When rotatedinto the same plane, as they are when applied, the monolithic componentsengage one another resulting in a preferred embodiment of the presentinvention.

[0016] In another embodiment, the present invention relates to a woundclosure device of the type described above, but having only a singleelongated connector extending from the first flat flexible component,and a single elongated connector extending from the second flat flexiblecomponent. This embodiment is preferred for use in connection withrelatively small wounds or incisions. Generally speaking, the width ofthe flat flexible components of this small wound embodiment is less thanabout ¾″. This preference for use in connection with relatively smallwounds or incisions is based on the fact that the elongated connectorextends from its corresponding flat flexible component in an offsetmanner (i.e., not from the center of the wound edge, but rather to oneside of the wound edge). If the flat flexible component weresufficiently wide, say two inches in width, attempts to effectadjustment of the wound edge could be distorted by flexing of thecomponents. On the smaller scales anticipated in connection with thisembodiment, the risk of this type of distortion is substantiallyeliminated.

[0017] By designing this embodiment so that the single elongatedconnector extends from its associated flat flexible component in anOffset manner, it is possible to apply each component of thetwo-component device such that the wound edge of each are substantiallyparallel and centrally aligned, with the elongated connectors of eachcomponent being substantially parallel. In use, the adhesive backedportion of the elongated connector extending from the first flatflexible component attaches to the second flat flexible component.Similarly, the adhesive backed portion of the elongated connectorextending from the second flat flexible component attaches to the firstflat flexible component. Care is taken during the design and manufactureprocess to ensure that adhesive is not applied to an elongatedconnection at a location which would result in contact between adhesiveand the wound.

[0018] A pulling element is provided which extends from each elongatedconnector on the side of the elongated connector opposite the associatedflat flexible component. In preferred embodiments, the pulling elementis removable once the device is secured. A perforation in the materialfrom which the device is constructed, along a line substantiallyperpendicular to the major axis of each elongated connector, is providedfor easy removal of the pulling element. Optional features of the typedescribed herein, in connection with other embodiments, are equallyapplicable to the single elongated connector embodiment.

[0019] When applied to the skin and appropriately tensioned, one edge ofthe first flat flexible component and one edge of the second flatflexible component are positioned nearest to and substantially parallelto the wound or incision. These edges will be referred to herein as thewound edges. In preferred embodiments of the present invention, thewound edges are adapted to evert (or raise) skin edges to promote woundhealing. It is known in the art that everting, raising or mounding ofthe skin edges at the wound or incision site prevents wound inversion.One way in which this may be accomplished is to provide a bend at thewound edge. The bend may be angled or arcuate. The adhesive on the lowerportion of the flat flexible components is also applied to the portionof the wound edge. When attached to the skin this eversion edge tends tolift the edges of the skin at the point of closure contact, therebypromoting wound or incision healing.

[0020] As mentioned above, preferred embodiments of the presentinvention include die cut embodiments. In such embodiment, the elongatedconnectors may be viewed as strap-like in their dimensions. In preferredembodiments, a portion of the elongated connectors is cut away toincrease the unobstructed surface area over the wound or incision. Thistends to facilitate drainage of exudates and application of medication.This cut-away is best made in a die cut process.

[0021] In preferred embodiments, the bandage of the present invention isalso adapted for wound closure alignment. Spacing between adjacentelongated connectors, as discussed above, is relevant to the issue ofwound closure alignment. Additionally, preferred embodiments of thebandage of the present invention include wound closure alignmentindicators. These alignment indicators are visual indicators whichappear on the flat flexible components near the wound edge. Typically,they will appear as a line or an arrow generally perpendicular to thewound or incision. In closing a wound or incision, a clinician typicallycloses the wound manually with his/her fingers at the approximatemid-point, then makes a small mark or line perpendicular to the woundwith a surgical pencil. These marks are used to align the deviceprecisely with the wound alignment indicators on the bandage of thepresent invention.

[0022] The bandage of the present invention can be optionally adaptedfor transdermal drug delivery. As is known in the art, a drug isdeliverable transdermally through the skin. For such an application, adrug-containing patch is secured to at least one of the flat flexiblecomponents in such a way that the drug can be delivered through theskin. Given the fact that there will be no adhesive contact between theskin and the flat flexible component in the area of the drug deliverypatch, it may be necessary to increase the size of the flat flexiblecomponent to secure the bandage in such a transdermal drug deliveryembodiment. Transdermal drug delivery is well known in the art and areview of the background is not necessary to enable one of skill in theart to make and use the present invention.

[0023] The bandage of the present invention may optionally include anelastic tension indicator element. The purpose of the tension indicatorelement is to provide a visual indication that a desired tension hasbeen reached while applying the bandage. For example, materials areknown in the art which change color when a predetermined tension isapplied. Similarly, other graphic representations may be used for thispurpose. For example, a rectangular graphic representation may beapplied to an elastic tension indicator element. As this tensionindicator is stretched, the graphic representation of the rectanglestretches. This element may be designed such that the desired tension isindicated when the original rectangular representation is stretched tothe point where it closely approximates a geometric square.

[0024] It is desirable that this elastic tension indicator element beremovable with the pulling elements following application of thebandage. At a minimum, the elastic tension indicator element should bepositioned in the bandage such that when the bandage is applied, it isnot possible for the elastic element to continue to stretch and releasethe desired tension previously established.

[0025] The present invention also relates to a method of wound closure.The method comprises applying the bandage described above in the mannerspecified.

[0026] The device of the present invention can also be adapted for skinstretching prior to a surgical procedure. Consider, for example, asituation in which a surgeon wishes to remove an abnormal skin patch. Ifthe skin patch is generally round, having a diameter of one inch, it iseasy to imagine the problem associated with closing the incisionresulting from its removal. Currently this problem is addressed bystretching the skin using an invasive procedure in which a balloon-likedevice is inserted beneath the skin, and inflated. Over a period ofdays, the skin above the device is stretched and the removal of theundesirable skin patch creates an opening in the skin which is much moreeasily closed.

[0027] The device of the present invention can be used to accomplishthis skin-stretching function. This is accomplished by placing the woundedges of each component of the two-component device on either side ofthe skin patch to be excised. The device is then tensioned as describedherein. In light of the fact that the distance between the two woundedges is relatively large in this application, the tension on the deviceis increased. To ensure adherence of the components of the device inthis skin-stretching embodiment, it is desirable to provide adhesive onthe pulling elements of the device. In this embodiment, not only are thecomponents secured by adhesive contact between the elongatedconnector(s) and flat flexible components, but also by adhesive contactbetween pulling elements and the skin. In this embodiment the pullingelements are not removed following application of the device.

BRIEF DESCRIPTION OF THE DRAWINGS

[0028]FIG. 1 is a perspective view illustrating a bandage of the presentinvention in a non-tensioned state.

[0029]FIG. 2 is a perspective view illustrating a bandage of the presentinvention with tension applied.

[0030]FIG. 3 is a perspective view illustrating a bandage of the presentinvention with elongated connectors secured to flat flexible componentsand pulling elements removed.

[0031]FIG. 4 is a perspective view illustrating a bandage of the presentinvention in non-tensioned a wide-keyhole embodiment.

[0032]FIG. 5 is a perspective view of a protective cover for applicationover the bandage of the present invention.

[0033]FIG. 6 is a perspective view of the protective cover of FIG. 6,applied to protect a bandage of the present invention.

[0034]FIG. 7 is a perspective view illustrating an embodiment of thepresent invention in which each component of the two-component devicecomprises only a single elongated connector.

[0035]FIG. 8 is a perspective view depicting the device of FIG. 7 inuse.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

[0036] A bandage of the present invention in a non-tensioned state isdepicted in FIG. 1. Bandage (1) includes a first flat flexible component(5) and a second flat flexible component (25). Each of these componentshas an upper surface to which lead lines 5 and 25 are directed, andlower surfaces which are not visible in the drawing. The lower surfacesare coated with adhesive to facilitate attachment to the skin. Aplurality of first elongated connectors (15) extend from the wound edge(20) of the first flat flexible component (5) in a first direction, anda plurality of second elongated connectors (35) extend from the woundedge (42) of the second flat flexible component in a second directionwhich is generally opposite to the first direction. A first pullingelement (40) is joined to the first elongated connectors (15) andadapted for lateral translation of the first flat flexible component (5)toward a wound or incision. Similarly, a second pulling element (45) isjoined to the second elongated connectors (35) and adapted for lateraltranslation of the second flat flexible component (25) toward the woundor incision. In preferred embodiments, the means for attaching the firstelongated connectors (15) to the second flat flexible component (25),and the second elongated connectors (35) to the first flat flexiblecomponent (5), comprise an adhesive. The adhesive may be applied to thelower surfaces of the first and second elongated connectors (15 and 35),or to the upper surfaces of the first and second flat flexiblecomponents (5 and 25). Perforations (17 and 37) in the elongatedconnectors facilitate removal of the pulling elements (40 and 45) fromthe elongated connectors (15 and 35) following application of thebandage.

[0037] Lower surfaces of the first and second flat flexible componentsare covered (at least partially) with adhesive to facilitate attachmentto the patient's skin. Such adhesives facilitate attachment and alloweasy removal of the bandage after the wound or incision has healed.Protective films (not shown), removable by hand, serve as means forprotecting the adhesive on the first and second flexible flat components(5 and 35) prior to use of the bandage.

[0038]FIG. 2 depicts the bandage of FIG. 1 in a tensioned, but non-fixedstate. More specifically, FIG. 2 depicts first and second flat flexiblecomponents (5 and 25) attached to the skin with adhesive. Tension hasbeen applied to pulling elements (40 and 45) thereby drawing wound edges(20 and 42) toward one another, thereby effecting wound closure.Elongated connectors (15 and 35) have not yet been fixed by adhesive tothe flat flexible components (5 and 25), thereby completing application.

[0039]FIG. 3 depicts the bandage of FIG. 1 in the tension and fixed(i.e., applied) state. Pulling elements 40 and 45 as shown in FIGS. 1and 3 have been removed along perforations 17 and 37. Elongatedconnectors 15 and 35 are attached to flat flexible components 5 and 25by adhesive. Cut-outs (47 and 49) in elongated connectors (35 and 15)are positioned directly above the wound or incision to facilitatedrainage of exudates and application of medication.

[0040] Referring to FIG. 4, an alternative embodiment of the bandage ofFIG. 1 is shown in which only a single elongated connector (15) isattached to the first flat flexible component (5). This embodiment isreferred to herein as a wide key-hole embodiment.

[0041] Referring to FIG. 5, a clear, breathable protective cover (51)having an adhesive strip (53) along the perimeter may be applied toprotect the area to which a bandage of the present invention has beenapplied. FIG. 6 depicts the protective cover (51) applied to the skinover a bandage of the present invention (1).

[0042]FIG. 7 is a diagrammatic representation of a two-component woundclosure device of the present invention. The first component of thetwo-component device is indicated by reference number 54, and the secondcomponent of the two-component device is indicated by reference number56. Each of the two components (54 and 56) have a single elongatedconnector (15 and 35) associated with each flat flexible component (5and 25). The single elongated connectors (15 and 35) extend from theirassociated flat flexible components (5 and 25) in an offset manner. Anexample of an adhesive application pattern, intended to be non-limiting,for securing the two components is shown by shading. In preferredembodiments, the adhesive is applied to each flat flexible component (5and 25), as well as a portion of the elongated connectors (15 and 35).Pulling elements (40 and 45) are provided for ease of application andadjustment of the two-components of the wound closure device.Perforations (17 and 37) are provided in preferred embodiments forremoval of the pulling elements. In FIG. 7, the position of theperforation is near the central region of the elongated connectors. Itwill be recognized that the positioning of the perforations (17 and 37)is a matter of design choice. Cut-outs (47 and 49) are also shown inFIG. 7. These cut-outs are intended to allow for drainage of woundexudates, as well as to facilitate application of medication to thewound area.

[0043] Referring to FIG. 8, in use, the offset enables the device to bepositioned such that each component (54 and 56) of the two componentdevice is aligned such that the wound edge of each (20 and 42) (i.e.,the edge of the flat flexible component positioned nearest the wound orincision) are substantially parallel and centrally aligned, withelongated connectors (15 and 35) substantially parallel. While FIG. 8depicts the offset of each elongated connector in its most extremeembodiment (i.e., one edge of each elongated connector extends linearlyfrom one edge of each flat flexible component), it is not necessary thatthe elongated connectors be so severely offset. The degree of offset issufficient when each component of the device can be positioned as taughtherein without the first and second elongated connectors making contactwith each other. When positioned, the adhesive backed portion of theelongated connector (15) extending from the first flat flexiblecomponent (5) attaches to the second flat flexible component (25).Similarly, the adhesive backed portion of the elongated connector (35)extending from the second flat flexible component (25) attaches to thefirst flat flexible component (5).

1. A two-component medical device comprising: a) a first componentcomprising a first flat flexible component having adhesive on a lowersurface and a single first elongated connector extending in an offsetmanner from one edge thereof in a first direction; b) a second componentcomprising a second flat flexible component having adhesive on a lowersurface and a single second elongated connector extending from one edgethereof in a second direction generally opposite to the first direction;c) a first pulling element joined to said first elongated connector andadapted for lateral translation of the first flat flexible componenttoward a wound edge; d) a second pulling element joined to said secondelongated connector and adapted for lateral translation of the secondflat flexible component toward the wound edge; and e) means forattaching the first elongated connector to the second flat flexiblecomponent and means for attaching the second elongated connector to thefirst flat flexible component.
 2. The medical device of claim 1 whereinelements a)-d) are produced from a substantially inelastic material orare produced from an elastic material which is reinforced with aninelastic structural component thereby rendering the devicesubstantially inelastic.
 3. The medical device of claim 1 which isadapted for removal of the first and second pulling elements followingattachment of the bandage.
 4. The medical device of claim 1, wherein thefirst and second pulling elements are rigid.
 5. The medical device ofclaim 1, wherein the first and second pulling elements are non-rigid,but are reinforced with a rigid element.
 6. The medical device of claim1 wherein elements a)-d) are die cut from sheet stock.
 7. The medicaldevice of claim 1 wherein the edges of the first and second flatflexible components which attach to the skin on opposing sides of awound or incision are adapted to evert skin edges to promote woundhealing.
 8. The medical device of claim 1 wherein the edges of the firstand second flat flexible components are angled or curved to evert theskin edges.
 9. The medical device of claim 1, wherein a portion of eachelongated connector is cut away to increase unobstructed surface areaabove the wound thereby facilitating drainage of exudates andapplication of medication.
 10. The medical device of claim 1, whereinthe first and second flat flexible components are adapted for woundclosure alignment.
 11. The medical device of claim 10 wherein saidadaptation comprises alignment marks on the first and second flatflexible components for alignment with each other and/or with marksplaced directly on skin.
 12. The medical device of claim 1, which isadapted for transdermal drug delivery.
 13. The medical device of claim 1further comprising an elastic tension indication element.
 14. Themedical device of claim 13 wherein the elastic tension indicationelement is removable with the pulling elements.
 15. The medical deviceof claim 1 further comprising a rigid polymer bar attached to the edgesof the first and second flat flexible components which are nearest toand substantially parallel the wound or incision.
 16. A method forclosing a wound or incision comprising the steps of: (a) providing amedical device comprising: i) a first flat flexible component havingadhesive on a lower surface and a first elongated connector extendingfrom one edge thereof in a first direction; ii) a second flat flexiblecomponent having adhesive on a lower surface and a second elongatedconnector extending from one edge thereof in a second directiongenerally opposite to said first direction; iii) a first pulling elementjoined to said first elongated connector and adapted for lateraltranslation of the first flat flexible component toward a wound edge;iv) a second pulling element joined to said second elongated connectorand adapted for lateral translation of the second flat flexiblecomponent toward the wound edge; vi) means for attaching the firstelongated connector to the second flat flexible component and means forattaching the second elongated connector to the first flat flexiblecomponent; and b) attaching said lower surface of said first flexiblecomponent to a patient's skin along a first side of a wound; c)attaching said lower surface of said second flexible component to thepatient's skin along a second side of said wound; d) pullingsimultaneously said first and second pulling elements until saidelongated connector is subjected to a tension sufficient to close thewound or incision; e) attaching said first elongated connector to saidsecond flexible component; and f) attaching said second elongatedconnector to said first flexible component.
 17. The method of claim 16further comprising the steps of: a) removing said first pulling elementfrom said first elongated connector; and b) removing said second pullingelement from said second elongated connector.
 18. The method of claim 16further comprising the steps of: a) attaching said first pulling elementto the patient's skin beside said second flat flexible component; and b)attaching said second pulling element to the patient's skin beside saidfirst flat flexible component.
 19. The medical device of claim 1 whereinthe elongated first and second elongated connector is sufficientlyspaced-apart to facilitate lateral adjustment of the first flat flexiblecomponent relative to the second flat flexible component.
 20. Themedical device of claim 1 wherein the pulling elements have adhesive onthe lower surface.
 21. A two-component medical device comprising: a) afirst component comprising a first flat flexible component and aplurality of first elongated connectors extending from one edge thereofin a first direction; b) a second component comprising a second flatflexible component having one or more second elongated connectorsextending from one edge thereof in a second direction generally oppositeto the first direction; c) a first pulling element joined to said firstelongated connectors and adapted for lateral translation of the firstflat flexible component toward a wound edge, the first pulling elementhaving adhesive on a lower surface; d) a second pulling element joinedto said second elongated connectors and adapted for lateral translationof the second flat flexible component toward the wound edge, the secondpulling element having adhesive on a lower surface; and e) means forattaching the first elongated connectors to the second flat flexiblecomponent and means for attaching the second elongated connectors to thefirst flat flexible component.
 22. The medical device of claim 21wherein elements a)-d) are produced from a substantially inelasticmaterial or are produced from an elastic material which is reinforcedwith an inelastic structural component thereby rendering the devicesubstantially inelastic.
 23. The medical device of claim 21 which isadapted for removal of the first and second pulling elements followingattachment of the bandage.
 24. The medical device of claim 21 whereinsaid first and second elongated connectors are interleaved.
 25. Themedical device of claim 21 wherein the first elongated connectors areadjacent to one another and centrally located, and the second elongatedconnectors flank the first elongated connectors at outside edges of thebandage.
 26. The medical device of claim 21, wherein the first andsecond pulling elements are rigid.
 27. The medical device of claim 21,wherein the first and second pulling elements are non-rigid, but arereinforced with a rigid element.
 28. The medical device of claim 21wherein elements a)-d) are die cut from sheet stock.
 29. The medicaldevice of claim 21 wherein the edges of the first and second flatflexible components which attach to the skin on opposing sides of awound or incision are adapted to evert skin edges to promote woundhealing.
 30. The medical device of claim 21 wherein the edges of thefirst and second flat flexible components are angled or curved to evertthe skin edges.
 31. The medical device of claim 21, wherein a portion ofthe elongated connector is cut away to increase unobstructed surfacearea above the wound thereby facilitating drainage of exudates andapplication of medication.
 32. The medical device of claim 21, whereinthe first and second flat flexible components are adapted for woundclosure alignment.
 33. The medical device of claim 32 wherein saidadaptation comprises alignment marks on the first and second flatflexible components for alignment with each other and/or with marksplaced directly on skin.
 34. The medical device of claim 21, which isadapted for transdermal drug delivery.
 35. The medical device of claim21 further comprising an elastic tension indication element.
 36. Themedical device of claim 35 wherein the elastic tension indicationelement is removable with the pulling elements.
 37. The medical deviceof claim 21 further comprising a rigid polymer bar attached to the edgesof the first and second flat flexible components which are nearest toand substantially parallel the wound or incision.
 38. A method forstretching skin prior to a surgical procedure comprising the steps of:a) providing a medical device comprising: i) a first flat flexiblecomponent having adhesive on a lower surface and a plurality of firstelongated connectors extending from one edge thereof in a firstdirection; ii) a second flat flexible component having adhesive on alower surface and one or more second elongated connectors extending fromone edge thereof in a second direction generally opposite to said firstdirection; iii) a first pulling element joined to said first elongatedconnectors and adapted for lateral translation of the first flatflexible component toward a wound edge, the first pulling element havingadhesive on a lower surface; iv) a second pulling element joined to saidsecond elongated connectors and adapted for lateral translation of thesecond flat flexible component toward the wound edge, the second pullingelement having adhesive on a lower surface; vi) means for attaching thefirst elongated connectors to the second flat flexible component andmeans for attaching the second elongated connectors to the first flatflexible component; and b) attaching said lower surface of said firstflexible component to a patient's skin; c) attaching said lower surfaceof said second flexible component to the patient's skin; d) pullingsimultaneously said first and second pulling elements until saidelongated connectors are subjected to a tension sufficient to stretchskin to the desired degree; e) attaching said first elongated connectorsto said second flexible component, and said first pulling element to thepatient's skin; and f) attaching said second elongated connectors tosaid first flexible component, and said second pulling element to thepatient's skin.
 39. The method of claim 38 further comprising the stepsof: a) removing said first pulling element from said first elongatedconnectors; and b) removing said second pulling element from said secondelongated connectors.
 40. The method of claim 38 further comprising thesteps of: a) attaching said first pulling element to the patient's skinbeside said second flat flexible component; and b) attaching said secondpulling element to the patient's skin beside said first flat flexiblecomponent.
 41. The medical device of claim 21 wherein the elongatedconnectors are sufficiently spaced-apart to facilitate lateraladjustment of the first flat flexible component relative to the secondflat flexible component.